Checklist for damage diagnosis in the event of an accident, form · of6000p100001fr · Mercedes-Benz WIS

OF60.00-P-1000-01FR

Checklist for damage diagnosis in the event of an accident, form

Model

257

________________________________________________________________________________________________________________________________
Company-owned sales and service outlet/Dealer no.	Customer


	__________________________________________________________
	Vehicle identification number	Repair order no.

	__________________________________________________________
	Tester: Name	Date

________________________________________________________________________________________________________________________________
License plate number Initial registration Model	Engine no.	Odometer reading: km/miles

Accident information from customer:

________________________________________________________________________________________________________________________________

Workshop remarks:

________________________________________________________________________________________________________________________________


Damage covered by comprehensive insurance:	☐	Damage covered by third-party liability insurance:	☐

Tire tread depth:

Front left: _________mm	Front right: __________mm

Rear left: ________ mm	Rear right: _________ mm


Performed:		Initial condition:
	Vehicle exterior:
		OK	Not OK

☐	Check condition of vehicle exterior.	☐	☐
☐	Check condition of vehicle gap dimensions.	☐	☐

Checklist for vehicle exterior:
Front area of vehicle
Visual inspection of detachable parts		OK	Not OK	Damage	Appraisal
					Repair	New part

Front area		☐	☐	_________________________________________	☐	☐
Engine hood		☐	☐	_________________________________________	☐	☐
Fender	Left	☐	☐	_________________________________________	☐	☐
	Right	☐	☐	_________________________________________	☐	☐
Bumper		☐	☐	_________________________________________	☐	☐
Lamp units		☐	☐	_________________________________________	☐	☐
Windows		☐	☐	_________________________________________	☐	☐
Front doors		☐	☐	_________________________________________	☐	☐
Other detachable parts		☐	☐	_________________________________________	☐	☐

Checklist for vehicle exterior:
Rear area of vehicle
Visual inspection of detachable parts		OK	Not OK	Damage	Appraisal
					Repair	New part

Fender	Left	☐	☐	_________________________________________	☐	☐
	Right	☐	☐	_________________________________________	☐	☐
Rear center section		☐	☐	_________________________________________	☐	☐
Trunk lid/liftgate		☐	☐	_________________________________________	☐	☐
Bumper		☐	☐	_________________________________________	☐	☐
Lamp units		☐	☐	_________________________________________	☐	☐
Windows		☐	☐	_________________________________________	☐	☐
Rear doors		☐	☐	_________________________________________	☐	☐
Other detachable parts		☐	☐	_________________________________________	☐	☐

Remarks on vehicle exterior:

________________________________________________________________________________________________________________________________

________________________________

Date and signature of mechanic

Checklist for vehicle gap dimensions:
Front area of vehicle
Gap dimension inspection	Dimension	OK	Not OK	Damage	Appraisal
					Repair	New part	Completed

Engine hood to fender	A	☐	☐	______________________	☐	☐	☐
Engine hood to bumper	B	☐	☐	______________________	☐	☐	☐
Protrusion of radiator trim/soft nose, engine hood	B1	☐	☐	______________________	☐	☐	☐
Bumper to fender	C	☐	☐	______________________	☐	☐	☐
Fender to headlamp	D	☐	☐	______________________	☐	☐	☐
Bumper to headlamp at bottom	E1	☐	☐	______________________	☐	☐	☐
Bumper to headlamp, side	E2	☐	☐	______________________	☐	☐	☐
Bumper to headlamp at top	E3	☐	☐	______________________	☐	☐	☐
Front door to fender	F	☐	☐	______________________	☐	☐	☐

Checklist for vehicle gap dimensions:
Rear area of vehicle
Gap dimension inspection	Dimension	OK	Not OK	Damage	Appraisal
					Repair	New part	Completed

Front door to rear door	G	☐	☐	______________________	☐	☐	☐
Rear door to side section, bottom	H	☐	☐	______________________	☐	☐	☐
Taillamp to bumper	I	☐	☐	______________________	☐	☐	☐
Trunk lid to bumper	J1	☐	☐	______________________	☐	☐	☐
	J2	☐	☐	______________________	☐	☐	☐
Fender at rear to taillamp	K	☐	☐	______________________	☐	☐	☐
Outside of taillamp to inside of taillamp	L	☐	☐	______________________	☐	☐	☐
B-pillar cover to front window	M	☐	☐	______________________	☐	☐	☐
B-pillar cover to rear window	N	☐	☐	______________________	☐	☐	☐
Trunk lid to fender at rear, top	O	☐	☐	______________________	☐	☐	☐
Fuel filler flap	P	☐	☐	______________________	☐	☐	☐
Side wall to bumper at rear	Q	☐	☐	______________________	☐	☐	☐
Trunk lid to rear window	R	☐	☐	______________________	☐	☐	☐

Remarks on vehicle gap dimensions:

________________________________________________________________________________________________________________________________

________________________________

Date and signature of mechanic


Performed:		Initial condition:
	Chassis:
		OK	Not OK

☐	Check condition of chassis components and vehicle underside.	☐	☐
☐	Perform wheel alignment check, if required.	☐	☐

Checklist for chassis components:
Front area of vehicle
Suspension components visual check	OK	Not OK	Damage	New part

Complete wheels	☐	☐	_________________________________________	☐
Front axle carrier	☐	☐	_________________________________________	☐
Steering components	☐	☐	_________________________________________	☐
Transverse control arm and wheel suspension	☐	☐	_________________________________________	☐
Suspension strut	☐	☐	_________________________________________	☐
Stabilizer bar or torsion bar linkage	☐	☐	_________________________________________	☐
Strut rod	☐	☐	_________________________________________	☐
Spring control arm	☐	☐	_________________________________________	☐

Remarks on chassis components:

________________________________________________________________________________________________________________________________

________________________________

Date and signature of mechanic

Checklist for chassis components:
Rear area of vehicle
Suspension components visual check	OK	Not OK	Damage	New part

Complete wheels	☐	☐	_________________________________________	☐
Rear axle carrier	☐	☐	_________________________________________	☐
Wheel suspension	☐	☐	_________________________________________	☐
Shock absorber	☐	☐	_________________________________________	☐
Spring control arm	☐	☐	_________________________________________	☐
Axle shaft	☐	☐	_________________________________________	☐
Camber strut	☐	☐	_________________________________________	☐
Tie rod	☐	☐	_________________________________________	☐
Thrust arm	☐	☐	_________________________________________	☐
Strut rod	☐	☐	_________________________________________	☐
Stabilizer bar or torsion bar linkage	☐	☐	_________________________________________	☐

Remarks on chassis components:

________________________________________________________________________________________________________________________________

________________________________

Date and signature of mechanic


Performed:		Initial condition:
	Visual inspection of structural components:

		OK	Not OK

☐	Perform visual check on structural components.	☐	☐
	Note: Before the structural components are inspected, the corresponding detachable parts must be removed.
	If cracks, folds or deformation (exception) are found, the respective structural component must always be replaced. Otherwise, the required minimum strength of the structural components can no longer be assured.
	Exception, in case of deformation only: The connecting flange on suspension strut tower for the front module carrier is conditionally capable of being straightened.

Checklist for structural components:
Front area of vehicle
Visual inspection of structural components		OK	Not OK	Damage	Appraisal
					Repair	New part

Suspension strut tower	Left	☐	☐	_______________________________________		☐
	Right	☐	☐	_______________________________________		☐
Connecting flange on suspension strut tower for front module carrier	Left	☐	☐	_______________________________________	☐	☐
	Right	☐	☐	_______________________________________	☐	☐

Checklist for structural components:
Rear area of vehicle
Visual inspection of structural components		OK	Not OK	Damage	Appraisal
					New part

Cross member above rear axle		☐	☐	_______________________________________	☐
Longitudinal member console	Left	☐	☐	_______________________________________	☐
	Right	☐	☐	_______________________________________	☐
Damper strut dome	Left	☐	☐	_______________________________________	☐
	Right	☐	☐	_______________________________________	☐

Remarks on structural components:

________________________________________________________________________________________________________________________________

________________________________

Date and signature of mechanic


Performed:		Initial condition:
	Measurement of structural components:
		OK	Not OK

☐	Carry out measurements on the structural components.	☐	☐
	Note: Measurement of structural components only in combination with approved electronic measuring systems.
	Note: Before the structural components are measured, the corresponding detachable parts must be removed and the bolts loosened between the flexural member and the crash box, the crash box and the longitudinal member, and the front axle carrier front and the body.


	If cracks, folds or deformation (exception) are found, the respective structural component must always be replaced. Otherwise, the required minimum strength of the structural components can no longer be assured.
	Exception, in case of deformation only: The connecting flange on suspension strut tower for the front module carrier is conditionally capable of being straightened.
	Information on straightening and reshaping, see "Information on machining aluminum components and vehicles"

Checklist for structural components:
Front area of vehicle
Structural component measurement		Actual value (deviation) in			Appraisal
		"X"	"Y"	"Z"	OK	Repair	New part

Suspension strut tower:
Measuring point 4	Left	____	____	____	☐		☐
	Right	____	____	____	☐		☐

Connecting flange on suspension strut tower for front module carrier:
Measuring point 5	Left	____	____	____	☐	☐	☐
	Right	____	____	____	☐	☐	☐

Checklist for structural components:
Rear area of vehicle
Structural component measurement		Actual value (deviation) in			Appraisal
		"X"	"Y"	"Z"	OK	New part

Crossmember above rear axle:
Measuring point 6	Left	____	____	____	☐	☐
	Right	____	____	____	☐	☐
Measuring point 7	Left	____	____	____	☐	☐
	Right	____	____	____	☐	☐

Longitudinal member console:
Measuring point 8	Left	____	____	____	☐	☐
	Right	____	____	____	☐	☐
Measuring point 9	Left	____	____	____	☐	☐
	Right	____	____	____	☐	☐

Shock-absorber strut tower:
Measuring point 10	Left	____	____	____	☐	☐
	Right	____	____	____	☐	☐

Remarks on structural components:

________________________________________________________________________________________________________________________________

________________________________

Date and signature of mechanic

All check performed?	YES	☐	NO	☐

Remark: _____________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________

________________________________		________________________________
Date and signature of service advisor		Date and signature of mechanic